Healthcare Provider Details

I. General information

NPI: 1952568776
Provider Name (Legal Business Name): VHACTX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 PEANUT DR
TEMPLE TX
76502-5289
US

IV. Provider business mailing address

332 PEANUT DR
TEMPLE TX
76502-5289
US

V. Phone/Fax

Practice location:
  • Phone: 979-255-2150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number740976
License Number StateTX

VIII. Authorized Official

Name: MRS. LESA MURRAY
Title or Position: NURSE MANAGER
Credential:
Phone: 254-743-0910